Home Care (concept)
The term Home Care (also: Homecare ), translated as home care , refers to programs in the Anglo-American language area that provide medical, nursing and technical care for patients in their home environment. This enables the patient to return home as quickly as possible, even if he or she still needs certain therapy and care measures due to the illness. Hospital stays are therefore shortened by home care and largely avoided as a result. The domestic continuation of a commenced in hospital therapy ensures team through a home care, which is usually from an established household or medical specialist is and homecare companies, which among other nurses employed (registered nurses) and home-economically active personnel. Patients who require home ventilation are prepared for this in a sub-acute care area , if necessary .
In Germany, the Federal Association of Medical Technology defines home care as the home care of a patient with aids and bandages that require explanation by trained specialists within the framework of medical outpatient therapy of a quality comparable to that guaranteed by the clinic. In this case, service providers are so-called homecare companies who, if necessary, take care of the transfer and transfer management from the inpatient to the outpatient environment and ensure the continued supply of therapy- necessary products and medical technology . However, they do not take on any basic or treatment care services . In this way, homecare companies in Germany differ from providers of home care , home nursing and specialized outpatient palliative care (SAPV) . In Berlin, the term homecare is also used colloquially for care in the SAPV, which is provided by the Home Care Berlin e. V. is coordinated.
Home Care in the USA
Home care was developed as a concept in the USA when it became apparent from around the 1970s that the increasing expenditure on health care was proving to be unsustainable in the long run.
Forerunner of the concept, to about the mid-20th century was usual home care in the sense of home care : The care of elderly and sick people was mainly done at home by relatives or service personnel, supplemented by medical house calls. With advances in medicine and medical technology , the hospital increasingly became the center of health care and nursing. Insurance companies soon only reimbursed treatments that were carried out in hospital. Diagnostics and therapeutic procedures have become more extensive, and hospital stays have become longer and more costly. This growth of the hospital system, which continued over decades, led to a high expenditure burden on the part of employers and the state, so that various measures to limit costs were gradually introduced, including the Diagnosis Related Groups classification system. As this significantly shortened hospital stays, there were gaps in treatment and aftercare for patients after discharge. These gaps are being closed by the rediscovered and modernized home care.
Home care consists of a combination of professional health and life support services. In cooperation with the attending physician, professional health services carry out, among other things, medical or psychological diagnostics, pain therapy, physiotherapy, speech therapy or occupational therapy, take care of wound care, administer medication and infusions. The services that support coping with everyday life predominantly include household chores such as preparing meals, running errands, shopping, but also providing medication. Health and nursing care is integrated primarily in the first few weeks after discharge, but also when the patient requires permanent physical support. All aspects of home care are based on the premise of caregiving . Most of the funding comes from Medicare and to a much lesser extent from Medicaid .
Significance in Germany
By ensuring medical therapies in the home, Home Care can improve the quality of life of chronically ill, multimorbid or disabled people. At the same time, it should counteract the rise in costs in the health system, close the coordination gap between all service providers involved in the system and support the independence of patients.
In Germany (due to the separation of health and long-term care insurance) there are different legal requirements for outpatient treatment and outpatient care and make a comprehensive care and assistance system difficult. The demographic trend in Germany shows that the number of older people will rise continuously in the next few years. Chronic illnesses in need of care are increasing in relation to acute illnesses. These developments suggest that the number of multimorbid patients in need of care will rise sharply in the next few decades. This development is offset by another trend: there will be fewer and fewer medical and nursing staff.
However, medical progress and the development of medical technology make it possible for some treatment-intensive and cost-intensive therapy methods to be outsourced from the hospital to the home. In this way, the wish of many patients for care in a familiar environment and for as independent and independent a life as possible is met.
Therapies that are carried out or continued in the home instead of in the hospital must be able to guarantee the same quality of care. In this way, complications and consequential costs due to improper product use or poor aftercare can be avoided. Homecare care ensures that outpatient care is largely equivalent to clinical treatment.
literature
- Wolfgang Hartig, Udo Richter, Hans-Joachim Schmoll (eds.): Home care concepts: Modern care alternatives in the treatment of chronically (seriously) ill patients. Zuckschwerdt Verlag, 2nd edition, Munich 2002, ISBN 9783886037506 .
Individual evidence
- ↑ Ernst Bahns: It all started with the Pulmotor. The history of mechanical ventilation. Drägerwerk, Lübeck 2014, p. 46.
- ↑ BVMed / DEGEMED conference on transfer management bvmed.de/de/bvmed.
- ^ LH Bernstein: Introduction to the Home Care Problem. Experience from the USA. In: Home care concepts: Modern care alternatives in the treatment of chronically (seriously) ill patients. Munich 2002, pp. 1–3.
- ^ LH Bernstein: Introduction to the Home Care Problem. Experience from the USA. In: Home care concepts: Modern care alternatives in the treatment of chronically (seriously) ill patients. Munich 2002, p. 6.
- ^ R. Steinbronn, M. Erbrich: Home Care from the perspective of the health insurance companies. In: Home care concepts: Modern care alternatives in the treatment of chronically (seriously) ill patients. Munich 2002, p. 17.
- ^ R. Steinbronn, M. Erbrich: Home Care from the perspective of the health insurance companies. In: Home care concepts: Modern care alternatives in the treatment of chronically (seriously) ill patients. Munich 2002, pp. 17-23.